Pediatric emergency care
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Pediatric emergency care · Feb 2004
Clinical course of urinary tract infections in infants younger than 60 days of age.
Although often managed differently than older children, no study has specifically described the clinical course of urinary tract infections (UTIs) in young infants. Our objective was to determine the risk of progression of illness and the pattern of fever resolution in infants younger than 60 days of age with Gram-negative rod UTIs. ⋯ Progression of illness in infants with Gram-negative rod UTIs is unlikely. Fever resolution is rapid. If subsequent studies concur with our findings, outpatient therapy or short-stay unit admission may become a viable management strategy.
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Pediatric emergency care · Feb 2004
Comparative StudyUnderdosing of acetaminophen by parents and emergency department utilization.
Fever is a common reason for parents to seek medical attention for their children. We conducted this study to document accuracy of parental administration of acetaminophen and to identify if parents who did not give an optimal dose would have decided not to come to the emergency department (ED) if the fever had diminished at home. ⋯ A significant portion of our population gives an underdose of acetaminophen, reflecting lack of knowledge or misuse. Based on parental reports, the majority of visits for fever might have been prevented, if parents had been successful in their effort to reduce temperature to below of what they considered as fever, but factors other than underdosing of acetaminophen probably encourage parents of febrile children to visit the ED.
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Pediatric emergency care · Feb 2004
Review Case ReportsAcute presentation of infected urachal cysts: case report and review of diagnosis and therapeutic interventions.
Urachal remnants, although relatively rare, masquerade as a large number of diverse disorders leading to a high rate of misdiagnosis. A typical case is reported in which a 10-year-old boy presented to the Emergency Department twice before being incorrectly diagnosed with a pelvic or lower abdominal periappendiceal abscess. Definitive diagnosis and treatment of an infected urachal cyst were made intraoperatively. A review and discussion of urachal remnants is presented, and a diagnostic algorithm and treatment plan is offered for this entity.
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Pediatric emergency care · Feb 2004
Case ReportsRetinal hemorrhages in an 8-year-old child: an uncommon presentation of abusive injury.
Retinal hemorrhages in pediatric patients have been best described as a component of shaken baby syndrome (SBS), which has been described almost exclusively in the infant/toddler population. We describe the occurrence of retinal hemorrhages in the setting of abusive injury in an older child. ⋯ This case emphasizes that the diagnosis of SBS is not limited to babies and that the possibility of abusive shaking injury should also be considered in older children presenting with intracranial pathology and retinal hemorrhages.
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Pediatric emergency care · Feb 2004
Success rates of pediatric intubation by a non-physician-staffed critical care transport service.
Previous researchers have found that institution of an endotracheal intubation (ETI) protocol into a large urban paramedic program resulted in low success rates and had no beneficial effects. The primary goal of the current study was to assess ETI success rates achieved by a small cadre of nonphysician critical care transport (CCT) providers. A secondary objective was to assess for association between ETI success and factors such as age group or ETI setting (eg, in-hospital, in-aircraft). ⋯ CCT crew airway management success was very high in all practice settings. These data support contentions that, with a high level of initial and ongoing training, nonphysician CCT crew can successfully manage pediatric airways in a variety of circumstances.